University at Buffalo, SUNY, Buffalo, NY, USA.
Ther Adv Respir Dis. 2011 Jun;5(3):207-16. doi: 10.1177/1753465811398372. Epub 2011 Mar 4.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are major contributors to the morbidity and mortality associated with this disease. Current approaches that likely reduce chronic obstructive pulmonary disease (COPD) exacerbations include smoking cessation, influenza and pneumococcal vaccinations, long-acting bronchodilator and inhaled corticosteroid therapy, pulmonary rehabilitation, and mucolytic drugs. However, with optimal treatment using all of these modalities, we are only able to reduce exacerbations by about 40%. A significant proportion of COPD exacerbations are bacterial, therefore long-term antimicrobial therapy could have a role in preventing exacerbations. Long-term antibiotic treatment in COPD regimens that are being evaluated include low-dose macrolide therapy, pulsed fluoroquinolone administration and the use of inhaled antibiotics. Although initial results have been promising with significant reductions in exacerbations with these regimens, additional studies are required to identify the appropriate patient and regimen and elucidate the risk-benefit as well as cost effectiveness of long-term antibiotics in COPD.
慢性阻塞性肺疾病（COPD）的急性加重（AECOPD）是导致该疾病发病率和死亡率的主要原因。目前可能减少 COPD 加重的方法包括戒烟、流感和肺炎球菌疫苗接种、长效支气管扩张剂和吸入皮质类固醇治疗、肺康复和黏液溶解药物。然而，即使使用所有这些方法进行最佳治疗，我们也只能将加重的次数减少约 40%。COPD 加重的很大一部分是细菌性的，因此长期抗菌治疗可能在预防加重方面发挥作用。正在评估的 COPD 方案中的长期抗生素治疗包括低剂量大环内酯类治疗、氟喹诺酮脉冲给药和吸入抗生素的使用。尽管这些方案在减少加重方面取得了初步的令人鼓舞的结果，但需要进一步的研究来确定合适的患者和方案，并阐明长期抗生素治疗 COPD 的风险效益以及成本效益。
